Polycystic Ovarian Syndrome (PCOS) is a common health condition that affects multiple systems in the body, including hormones, reproductive health, and metabolism. While the exact number of people affected is unknown, research estimates that 6–13% of women have PCOS.

What is PCOS?

If someone has PCOS, their ovaries (the female reproductive organs that produce and release eggs) create excess androgens (sex hormones). Sometimes androgens are mistakenly referred to as “male sex hormones”, but every person has androgens- men just typically have more. Testosterone is the main androgen that people have.

The exact cause of PCOS is still unknown. The condition typically becomes apparent after puberty and may present differently from person to person.

What are the symptoms of PCOS?

There are many symptoms of PCOS, and a woman does not need to have all of them to be diagnosed with the condition. These include:

  • Irregular periods. This could mean:
    1. Amenorrhea (absent periods)
    2. Oligomenorrhea (infrequent periods, more than 35 days apart/ fewer than 6 periods in a year), and/ or
    3. Dysmenorrhea (painful periods). This is the most commonly reported symptom of PCOS.
  • Excessive facial and body hair (hirsutism). Approximately 70% of people with PCOS experience abnormal hair growth on the face, arms, chest, and/ or abdomen.
  • Obesity affects between 40-80% of those diagnosed with PCOS.
  • Acne, which typically continues past the teenage years and can be resistant to conventional treatments.
  • Thinning hair, or bald patches on the scalp.
  • Darkened skin patches (acanthosis nigricans), often in folds of skin such as the armpits, groin, and under the breasts.
  • Skin tags (small, benign flaps of excess skin), often in the folds of skin such as the armpits, groin, and under the breasts. They can also develop on eyelids.
  • Ovarian cysts (small, fluid-filled sacs which develop in or on the ovaries).
  • Infertility. Not ovulating regularly or frequently can make it more difficult to become pregnant.

It is possible to have PCOS without knowing it, as symptoms may be mild. Sometimes difficulty becoming pregnant is the first sign that a person has PCOS.

How is PCOS Diagnosed?

If you suspect you have PCOS, talk to your healthcare provider about the symptoms you have noticed. They may recommend the following tests:

  • A physical examination
  • Blood tests
  • An ultrasound of the ovaries

Your healthcare provider will ask you questions about your medical history, and it can be helpful to keep a diary of your periods and associated symptoms. Here is a example of a template diary from the Center for Young Woman’s Health.

To receive a diagnosis of PCOS, you will have symptoms in at least two out of these three categories:

  • Irregular or missed periods
  • Signs of excess androgens
  • Enlarged ovaries or excessive ovarian cysts on ultrasound

How is PCOS Treated?

Treatment options for PCOS varies from person to person, depending on symptoms and fertility goals. Your healthcare provider will discuss your options with you to make a personalized treatment plan.

Symptom Management

  • Hormonal birth control, such as the pill or patch, can be prescribed to regulate your menstrual cycle and manage acne and hair growth.
  • Insulin management medications, typically used to treat diabetes, to help your body process insulin more effectively.
  • Lifestyle changes, such as eating a nutritious, balanced diet and getting regular exercise, are recommended for everyone, and can help with physical symptoms as well as supporting your mental health.

Fertility Support

For those who are trying to conceive, medications to induce ovulation (have the ovary release an egg) may be prescribed. Others may choose to use IVF (in vitro fertilization) or other ART (assisted reproductive technologies). See our page here on ART here for more information.

Other Considerations

PCOS can feel isolating, and connecting with a counsellor or therapist can help. Online support groups can help you feel less alone in your health journey, check out The Seasons Collective and PCOS Together to find peer-to-peer support.

Take-Home Message

PCOS is a relatively common condition that can affect hormones, metabolism, and fertility. While there is no cure for PCOS, symptoms can often be managed successfully. Speak with your healthcare provider if you are experiencing any symptoms of PCOS to discuss which investigations and treatment options could be right for you.

Additional Resources